Six Routes to Unsupervised Clinical Practice

Wijnen-Meijer, Marjo; Broek, Mirte van den; Cate, Olle ten

doi:10.1097/acm.0000000000003880

Cited by 3 publications

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“…Since our findings are based on data from one medical school in Germany they cannot be extrapolated to other medical schools without further consideration. However, the German model of medical education being common in Europe, we have reason to believe that study populations at other medical schools may be similar and our findings of value to their curricular designers [ 49 ].…”

Section: Discussionmentioning

confidence: 94%

Integrated clinical case discussions – a fully student-organized peer-teaching program on internal medicine

et al. 2022

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Background In response to students´ poor ratings of emergency remote lectures in internal medicine, a team of undergraduate medical students initiated a series of voluntary peer-moderated clinical case discussions. This study aims to describe the student-led effort to develop peer-moderated clinical case discussions focused on training cognitive clinical skill for first and second-year clinical students. Methods Following the Kern Cycle a didactic concept is conceived by matching cognitive learning theory to the competence levels of the German Medical Training Framework. A 50-item survey is developed based on previous evaluation tools and administered after each tutorial. Educational environment, cognitive congruence, and learning outcomes are assessed using pre-post-self-reports in a single-institution study. Results Over the course of two semesters 19 tutors conducted 48 tutorials. There were 794 attendances in total (273 in the first semester and 521 in the second). The response rate was 32%. The didactic concept proved successful in attaining all learning objectives. Students rated the educational environment, cognitive congruence, and tutorials overall as “very good” and significantly better than the corresponding lecture. Students reported a 70%-increase in positive feelings about being tutored by peers after the session. Conclusion Peer-assisted learning can improve students´ subjective satisfaction levels and successfully foster clinical reasoning skills. This highlights successful student contributions to the development of curricula.

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Section: Discussionmentioning

confidence: 94%

Integrated clinical case discussions – a fully student-organized peer-teaching program on internal medicine

et al. 2022

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“…As our findings are based on data from one medical school in Germany, the results cannot automatically be generalised to other populations. But since the structure of medical education in Germany is the most common model for medical education worldwide [ 45 ], there are no reasons to assume that the study population is very different. However, a similar study in other countries is desirable.…”

Section: Discussionmentioning

confidence: 99%

Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

et al. 2022

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Background In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs. Methods We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program. Results Based on the answers of 442 students from study years 3–6, the most frequently chosen reason for not participating in the program is “identification with another discipline” with 61.0%, directly followed by “not willing to commit long-term” (56.1%). In third place is “personal connections to another region” with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them. Conclusions Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.

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For which entrustable professional activities must medical students be prepared if unsupervised patient care without further training is an expectation? An international Global South study

ten Cate,

Nel,

Hennus

et al. 2024

BMJ Glob Health

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IntroductionTraining medical students requires objectives that are often translated into frameworks of competencies. Since the introduction of entrustable professional activities (EPAs), these tasks or ‘units of professional practice’, originally conceived for postgraduate training, define what residents must be prepared to do unsupervised. Nowadays, EPAs are also applied to undergraduate training, with the prospect of entering residency. However, in many countries, especially in the Global South, a substantial number of medical graduates will be working in healthcare with little or no supervision and no further training soon or ever. EPAs for these conditions cannot be copied from undergraduate medical education EPA frameworks in Global North countries.MethodsWe conducted a generative investigation to identify and elaborate EPAs for Global South countries who must train students for unsupervised general practice. We included 39 medical educators from 13 Global South countries and 17 specialties in either one of two online focus group sessions using a nominal group technique (NGT) or as Delphi panel member. Results from the two NGT sessions were merged and fed into the two-round Delphi investigation.ResultsA framework of 11 EPAs resulted, each with an elaborate description (specification, setting and limitations).ConclusionThis framework of undergraduate medical education Global South EPAs differs in its nature and specifications from existing Global North EPAs. The authors do not pretend universality for all Global South countries with graduates who face expectations of unsupervised practice but present it to support countries that consider introducing the model of entrustable professional activities.

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Six Routes to Unsupervised Clinical Practice

Cited by 3 publications

References 0 publications

Integrated clinical case discussions – a fully student-organized peer-teaching program on internal medicine

Integrated clinical case discussions – a fully student-organized peer-teaching program on internal medicine

Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

For which entrustable professional activities must medical students be prepared if unsupervised patient care without further training is an expectation? An international Global South study

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